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Organization

ATHENS PSYCHOLOGICAL SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOSEPH E. MASON (CEO)
(706) 548-8697
Entity
Organization

Contact information

Practice address
1090 FOUNDERS BLVD, STE. B, ATHENS, GA 30606-6163
(706) 548-8697
(706) 548-8698
Mailing address
1090 FOUNDERS BLVD, STE. B, ATHENS, GA 30606-6163
(706) 548-8697
(706) 548-8698

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY002674
GA
103TB0200X
Cognitive & Behavioral Psychologist
PSY002674
GA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY002674
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
050836150C
GA
01
10034544
AMERIGROUP
01
556185000
MAGELLAN
Enumeration date
03/28/2012
Last updated
03/28/2012
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